The present invention relates to surgical procedures for providing autografts for use in coronary artery bypass surgery and, in particular, to a procedure for the minimally invasive harvesting of veins such as the saphenous vein for use as a bypass autograft.
Vascular complications produced by atherosclerosis, such as stenosis, aneurysm, rupture or occlusion, in which the atherosclerosis disease is advanced and the health of a patient is jeopardized, call for surgical intervention. If the disease is extensive, the affected artery or other vessel is no longer reliable and usually is replaced or bypassed by a bypass graft, usually referred to as an "autograft." To this end, the involved section of the vessel is transected and ligated at a point distal to the stenosis, occlusion, etc., and a replacement graft is sutured to the vessel, as for example, by anastomosis surgery, to provide a bypass path for blood flow. In a patient who undergoes coronary artery bypass grafting (CABG) surgery, a non-critical artery or vein is harvested from elsewhere in the body and is sewn into place in such a manner that reestablishes the flow of blood to the heart region that had lost its supply of blood because of the atherosclerotic occlusion.
The saphenous vein in the leg is the vessel that is most commonly harvested for use as a bypass graft in coronary artery surgery. However, typical procedures for harvesting a saphenous vein autograft are tedious, time consuming, and cause undesirable patient trauma. In one harvesting procedure, an incision is made along the leg for a length corresponding to the length of the autograft required, wherein the vein is transected and is stripped from the leg. The incision then must be sutured or stapled along its length. In some patients, the incision must be made along the entire length of the leg. The surgery required for harvesting a graft in this manner is traumatic to the patient, increases recovery time, increases the patient's hospital confinement, and adds to the cost of the coronary artery surgery.
Accordingly, it would be highly desirable to provide a less invasive procedure for harvesting the saphenous vein for a CABG procedure which avoids the need for a long incision and subsequent stitching, while reducing the trauma and the recovery time experienced by the patient.